ABSTRACT I have two overall career goals, which directly align with the aims of this proposal: 1) to perform high quality patient- oriented research in geriatric oncology that will provide critically-needed evidence to improve the care of older adults with cancer; and 2) to mentor the next generation of geriatric oncology researchers in patient-oriented research in order to ensure that there is a healthy cadre of well-trained geriatric oncology researchers poised to lead the field in the future. This is important because one in three Americans over the age of 60 will be diagnosed with cancer in their lifetime. From 2010 to 2030, cancer incidence is expected to rise 67% for individuals age ? 65. Despite the fact that older adults comprise the majority of cancer cases, they are severely underrepresented in cancer research studies. In addition, few physicians are dually trained in geriatrics and oncology, or focus on geriatric oncology research. The goal of this K24 Midcareer Investigator Award in Patient-Oriented Research is to: 1) unite the fields of geriatrics and oncology by studying geriatric correlates of vulnerability to chemotherapy toxicity and interventions to improve outcomes in an aging oncology population and 2) mentor the next generation of geriatric oncology researchers. There are three components proposed in this application. The first is a comprehensive mentoring program to foster the career development of trainees from diverse backgrounds by teaching patient-oriented research skills for geriatric oncology. This includes the development of a career development plan that will enable each mentee to learn the skills of patient-oriented research, including formulation and execution of a research project; 1:1 mentor- mentee meetings; and seminars and coursework to foster mentees' career development. The second component is to conduct patient-oriented research focused on improving the care of older adults with cancer. The proposed research in this application builds upon five prospective multicenter studies to develop a Geriatric Assessment Tool for oncologists and to identify predictors of chemotherapy toxicity. These studies serve as a platform to perform the following specific aims in patients age > 65 who are scheduled to receive a new chemotherapy regimen: 1) To identify geriatric clinical and biological predictors of outcomes (chemotherapy toxicity, hospitalization, functional decline, and survival) and to utilize these rich datasets as a means of mentoring the next generation of geriatric oncology researchers; and 2) To develop and test a geriatric assessment intervention to decrease the risk of chemotherapy toxicity and to understand treatment preferences in older adults with cancer. The third component of this application is my own career development plan, which will include expanding my research skill set to transition from observational to intervention to implementation research, and expanding my leadership skill set through coursework and 1:1 mentoring. The research and training proposed in this application address key priorities identified by the Institute of Medicine, the National Institute on Aging, and the National Cancer Institute to improve the care of older adults with cancer.